nanomaterials

Article
Solid Plasmonic Substrates for Breast Cancer
Detection by Means of SERS Analysis of
Blood Plasma
Gabriela Fabiola S, tiufiuc 1,† , Valentin Toma 2,† , Mihail Buse 2 , Radu Mărginean 2 ,
Gabriela Morar-Bolba 3 , Bogdan Culic 4 , Romulus Tetean 1 , Nicolae Leopold 1 , Ioana Pavel 5 ,
Constantin Mihai Lucaciu 6, * and Rares, Ionut, S, tiufiuc 2,6, *
1 Faculty of Physics, “Babes, -Bolyai” University, M. Kogalniceanu 1, 400084 Cluj-Napoca, Romania;
gabi.stiufiuc@phys.ubbcluj.ro (G.F.S, .); romulus.tetean@phys.ubbcluj.ro (R.T.);
nicolae.leopold@phys.ubbcluj.ro (N.L.)
2 MedFuture Research Center for Advance Medicine, “Iuliu Hat, ieganu” University of Medicine and
Pharmacy, L. Pasteur 4-6, 400349 Cluj-Napoca, Romania; valentin.toma@umfcluj.ro (V.T.);
buse.mihail@umfcluj.ro (M.B.); margi.radu@outlook.com (R.M.)
3 Department of Senology, The Oncology Institute “Prof. Dr. Ion Chiricuta”, 34-36 Republicii Street,
400015 Cluj-Napoca, Romania; gabrielambolba@yahoo.co.uk
4 Department of Dental Propedeutics and Esthetics, “Iuliu Hat, ieganu” University of Medicine and Pharmacy,
8 V. Babes Street, 400012 Cluj-Napoca, Romania; bculic@umfcluj.ro
5 Department of Chemistry, Wright State University, 3640 Colonel Glenn Hwy., Dayton, OH 45435-0001, USA;
ioana.pavel@wright.edu
6 Department of Pharmaceutical Physics-Biophysics, “Iuliu Hat, ieganu” University of Medicine and Pharmacy,
L. Pasteur 6, 400349 Cluj-Napoca, Romania
* Correspondence: clucaciu@umfcluj.ro (C.M.L.); rares.stiufiuc@umfcluj.ro (R.I.S, .);
Tel.: +40-74-4647-854 (C.M.L.); +40-72-6340-278 (R.I.S, .)
† These authors equally contributed to this paper.




Received: 11 May 2020; Accepted: 17 June 2020; Published: 21 June 2020


Abstract: Surface enhanced Raman spectroscopy (SERS) represents a promising technique in providing
specific molecular information that could have a major impact in biomedical applications, such as
early cancer detection. SERS requires the presence of a suitable plasmonic substrate that can generate
enhanced and reproducible diagnostic relevant spectra. In this paper, we propose a new approach
for the synthesis of such a substrate, by using concentrated silver nanoparticles purified using the
Tangential Flow Filtration method. The capacity of our substrates to generate reproducible and
enhanced Raman signals, in a manner that can allow cancer detection by means of Multivariate
Analysis (MVA) of Surface Enhanced Raman (SER) spectra, has been tested on blood plasma samples
collected from 35 healthy donors and 29 breast cancer patients. All the spectra were analyzed
by a combined Principal Component-Linear Discriminant Analysis. Our results facilitated the
discrimination between healthy donors and breast cancer patients with 90% sensitivity, 89% specificity
and 89% accuracy. This is a direct consequence of substrates’ ability to generate diagnostic relevant
spectral information by performing SERS measurements on pristine blood plasma samples. Our results
suggest that this type of solid substrate could be employed for the detection of other types of cancer
or other diseases by means of MVA-SERS procedure.

Keywords: SERS; solid plasmonic substrates; biofluids; MVA-SERS based cancer detection

Nanomaterials 2020, 10, 1212; doi:10.3390/nano10061212 www.mdpi.com/journal/nanomaterials

Nanomaterials 2020, 10, 1212 2 of 15

1. Introduction
Nowadays, screening for known cancer biomarkers is considered to be one of the most successful
strategies for cancer prevention, diagnosis and/or improvement of survival rate [1,2], as opposed
to traditional cancer screening methods which do not consistently provide the desirable results.
For instance, in the case of breast cancer screening by means of mammography, there is little or no
evidence that it contributes to reduced mortality rate [3]. An explanation for this unexpected outcome
arises due to the fact that mammography screening has led to a significant increase in over-diagnosis,
while the number of advanced breast cancer patients discovered through mammography remained
practically unchanged [4,5]. As breast cancer (BC) is the leading cause of death related to neoplastic
disease in women worldwide [6], an alternative screening method with substantial benefits is urgently
needed. Furthermore, this challenge exists for all types of cancer, but according to recent reports [7]
there is a strong belief that surface enhanced Raman spectroscopy (SERS)-based strategies could bring
a major improvement in this area, that is beneficial, not only for researchers, but most importantly for
patients. Given that blood tests are routinely used to monitor health condition [8], an ideal solution
for the issue might be introducing a simple, time and cost-effective blood test that could accurately
discriminate between healthy and diseased patients in a very reproducible manner [9]. The three
aforementioned criteria are often met by optical analytical approaches, out of which vibrational
spectroscopy techniques have the greatest advantage in providing “molecular fingerprints” of complex
biological mixtures with no need for extrinsic labeling [10].
Raman spectroscopy is particularly desirable from this point of view, as it is not limited by water
contributions, sequentially emerging as a powerful analytical method that allows for the examination
of a great variety of samples. A hot topic regarding the use of this technique is in the analysis of
biological samples, including fluids (e.g., blood and derivatives, saliva, urine), cells and tissue [10,11].
Amongst these, blood and its derivatives represent the richest source of vibrational information
regarding physiological and pathological processes that take place all over the organism, particularly
due to the fact that it circulates through all body structures. Raman spectroscopy has proven to be
a valuable analytical tool in bio-detection and molecular mapping studies, and subsequently new
exciting applications in the field of cancer diagnosis and prognosis are emerging [12,13]. Unfortunately,
this technique possesses quite a low sensitivity and can be often accompanied by a high fluorescence
background. These drawbacks restrain its applicability in the analysis of low concentration samples
such as the ones obtained from bio-fluids [11,13,14]. In principle, these limitations can be overcome by
means of several derived techniques, such as surface enhanced Raman spectroscopy (SERS) or resonant
Raman spectroscopy (RRS). SERS has the advantage of fluorescence quenching, a significantly higher
sensitivity and a spatial resolution, lower than the diffraction limit of white light optical microscopic
techniques. Its use in biological applications encounters several issues related to the non-specific
interaction of the plasmonic substrates, with highly complex biological samples, especially blood and
its derivatives. One of the biggest problems that needs to be overcome is the random attachment
of proteins (the main molecular constituents of blood plasma and serum) to the SERS substrates.
This phenomenon leads to a full coverage of the active sites, meaning that other molecules of interest
cannot reach these spots [14]. So far, several strategies have been developed for obtaining a reproducible
SERS fingerprint of blood samples. Bonifacio et al. have demonstrated that the fastest and most
efficient method of rapidly collecting Surface Enhanced Raman (SER) spectra is after deproteinization
of the blood serum [15]. The analysis of the experimental SER spectra allowed them to separate cancer
patients from healthy subjects [16]. However, the most important requirement consists in obtaining
plasmonic substrates capable of generating consistent and scientifically relevant SER spectra [17].
Over the years our group has developed several original synthesis methods for silver [18]
and gold [19–22] nanoparticles (NPs). They possess interesting plasmonic properties allowing the
detection of analytes at low concentrations or even chiral discrimination by means of SERS [23,24].
Herein, we propose a straightforward synthesis method for solid SERS-active substrates, based on
silver colloids that were purified and concentrated via the tangential flow filtration (TFF) technique.
Nanomaterials 2020, 10, 1212 3 of 15

The proposed solid plasmonic substrates facilitate the generation of reproducible SER spectra in the
case of blood plasma samples collected from a statistical relevant number of donors (n = 35) and BC
patients (n = 29), even when using an excitation wavelength from the NIR region (785 nm). A careful
examination of these spectra revealed that plasmatic small biomolecules contribute significantly to
large proteins, probably due to their higher affinity for this type of solid silver plasmonic substrate
(SSPS). As such, the first major goal of this study was to prove that a successful SERS-based cancer
detection method begins with the production of a suitable plasmonic substrate. In the case of SERS
measurements on biofluids, this substrate has to be able to generate reproducible and “diagnostic
relevant” vibrational spectra that will be further analyzed by means of Multivariate Analysis.
By performing a combined Principal Component Analysis-Linear Discriminant Analysis
(PCA-LDA) of the experimental SER spectra recorded on our solid substrates we were able to
discriminate with high sensitivity, specificity and accuracy (90% sensitivity, 89% specificity, 89%
accuracy) the healthy donors’ group from BC patients’ group.
The obtained results emphasize the major role played by the plasmonic substrates in SERS
measurements performed on blood plasma and open the possibility for using the here presented solid
substrates for SERS-based detection of other types of cancer. Nevertheless, it should be noted that
the purpose of this article is not to not to characterize the biological relevancy of BC or its detection.
This will be addressed in future research. We emphasize the importance of the substrate towards SERS
analysis as we believe it is the best way to attain reproducible and diagnostic relevant results.

2. Materials and Methods

All the chemicals utilized in this study were of analytical grade and used just as it is
from the producer company, without further purification. More specifically, the silver nitrate
(AgNO3 ) and hydroxylamine (NH2 OH) were purchased from Roth GmbH (Gladbach, Germany).
The subsequent aqueous solutions explicitly utilized in the experimental procedures were prepared
using ultrapure water (18.2 MΩ × cm, ELGA Labwater from PURELAB Chorus, Buckinghamshire,
UK). Lastly, the synthesis of solid plasmonic SERS substrates entailed using CaF2 polished glasses
(20 mm diameter and 1 mm thickness, purchased from Crystran Limited, Poole, UK) as port-probes for.

2.1. Synthesis of Silver Colloids

The procedure proposed by Leopold and Lendl was used to synthesize the hydroxylamine reduced
silver colloids (AgHya) [25]. A total of 90 mL of ultra-purified water was used to dissolve 10.5 mg of
hydroxylamine hydrochloride and 12 mg of sodium hydroxide in a Simax ISO blue capped glass bottle
of 250 mL. In a second bottle of the same making, 17 mg of silver nitrate was dissolved in 10 mL of
ultra-purified water. Under vigorous stirring conditions, this solution was promptly poured in the
previous one. It should be noted, that if the protocol is followed correctly, the final solution should
quickly change color from colorless to brown and finally to yellowish grey over the course of 5 min.
Once the synthesis process completed, tangential flow filtration (TFF) technique was implemented for
the purification and concentration of the NPs, as described in the literature [26,27]. This step turned
out to have a major role in the synthesis of suitable substrates for SERS measurements performed on
bio-fluids. Firstly, it removes the chemical byproducts resulting from the synthesis procedure allowing
a better interaction of the small biomolecules with the silver substrate. Secondly, this procedure reduces
the dimensional polydispersity of the AgHya NPs, favoring the reproducibility of the SER spectra.

2.2. Preparation of the Plasmonic Solid Substrates

The TFF-processed colloidal solutions were subsequently used as the foundational building blocks
in the synthesis of solid plasmonic substrates. First, the CaF2 glass were prepared by cleansing with
acetone and ethanol, rinsing with ultrapure water and left to air dry. After 15 min, a plate heater
was used to heat the port-probe at 40 ◦ C. In the final step, a 1 µL volume of concentrated colloid was
Nanomaterials 2020, 10, 1212 4 of 15

pipetted on the CaF2 port-probe and left to dry 80 s. The as-obtained SERS solid substrates were
removed from the heated plate and cooled down to room temperature; in this state, they ready for use.

2.3. Analyte Deposition for SERS Measurements

A 1 µL volume of blood plasma was pipetted on the dry, solid substrates. The deposited analytes
were left to air dry inside a refrigerator (~4 ◦ C) for 1 h before proceeding with the SERS measurements.

2.4. UV-VIS Absorption Measurements

A T92+ UV-VIS Spectrophotometer from PG Instruments Ltd. (Leicestershire, UK) was used to
record the UV-VIS absorption spectra. The absorption curves were acquired on standard quartz cells at
room temperature in the 300–800 nm spectral range. Lastly, the spectral resolution was set at 2 nm.

2.5. TEM and EDS Measurements

The HT7700 (Hitachi Ltd., Tokyo, Japan) Transmission Electron Microscope (TEM) was used
to execute the electron microscopy measurements and the Energy Dispersive Spectroscopy (EDS),
operating at 100 kV and using the high-resolution operation mode (spot size 3 = 0.60 µm). The samples
were deposited on carbon films on top of copper grids for 2–5 min; the time is dependent on sample
type and concentration. After deposition, the excess solution was blotted away using No. 42 ashless
filter paper and the grids were left covered at room temperature to completely dry. The obtained images
were calibrated for size, annotated, and processed (contrast enhancement by histogram stretching,
smoothing (sigma = 2.2) and cropping) using the ImageJ software (National Institutes of Health,
Bethesda, MD, USA).

2.6. Raman and SERS Measurements

The Raman and SERS spectra were measured using the Renishaw™ inVia Reflex Raman (Renishaw
plc, Gloucestershire, UK) confocal multilaser spectrometer at a resolution of ~1 cm−1 . An internal
silicon reference was used for calibration. The SERS/Raman measurements were achieved using small
amounts (~1 µL) of analytes; these analyte droplets were pipetted and left to dry, either on solid
plasmonic substrates, or directly on CaF2 glass. The 50× (N.A = 0.75) objective lens was used to
record the spectra. A 785 nm diode laser was used for excitation. The laser power (measurements
relative to the sample surface) was less than 65 mW, while the acquisition time was set to 10 s. The
spectrograph was equipped with a 1200 lines/mm grating and a charge coupled device camera (CCD).
Baseline correction was applied to all SERS spectra, in order to eliminate the fluorescence background.
Each spectrum represents the average of minimum 30 spectral acquisitions, collected on different
randomly chosen regions of the substrate. The baseline correction was performed by using the Wire
4.2 software provided by Renishaw (Gloucestershire, UK), with the inVia spectrometer.

2.7. AFM Measurements

Using the NT-MDT NTegra Vita system (NT-MDT Spectrum Instruments, Zelenograd, Russia)
mounted on an inverted Olympus IX73 optical microscope, atomic force microscopy (AFM) experiments
were performed under ambient conditions. The measurements were done in semi-contact mode,
using Si3 N3 tips having a resonant frequency of 235 kHz and a force constant of 12 N/m. The typical
curvature radius of the tips is ~10 nm. The images captured different regions of the solid plasmonic
substrates using the topographic and phase contrast mode.

2.8. NTA Measurements

Nanoparticle Tracking Analysis (NTA) measurements were done using a ZetaView®
NTA-Nanoparticle Tracking Video Microscope PMX-120 (Particle Metrix GmbH, Inning am Ammersee,
Nanomaterials 2020, 10, 1212 5 of 15

Germany). A 1000 times dilution was done for all colloids with ultra-purified water, before injecting
the samples in the device. The recording parameters were automatically set before each analysis.

2.9. Research Ethics

All subjects gave their informed consent for inclusion before they participated in the study.
The study was conducted in accordance with the Declaration of Helsinki 2013, and the protocol was
approved by “Iuliu Hatieganu” University’s Ethics Committee. The reference number for this approval
is 206/16.05.2017.

2.10. Cohort of Patient Samples

A number of 29 female BC patients and 35 healthy donors were enrolled in the study, as previously
mentioned, with informed consent. The samples for the breast cancer (BC) patients were collected
immediately after the cancer diagnosis and, therefore, no therapy or treatment interfered with our
analyte for the measurements. The patient ages ranged between 32 and 77 years with a median of
54.91 years. In the case of the healthy donors, the ages ranged between 35 and 55 years with a median of
51.54 years. Among the BC patients, the molecular subtypes measured were; 22 luminal B, 6 luminal A,
5 triple negative and one luminal HER2 positive, with stages between I and IV.

2.11. Blood Plasma Collection

The blood samples were obtained from the antecubital vein of healthy donors and BC patients
using Becton Dickinson vacutainers containing citrate. Immediately after collection, blood tubes were
centrifugated at 2600× g for 10 min in order to separate the plasma from the rest of the blood. Once the
separation procedure finished, the blood plasma was removed from the tube and stored at −80 ◦ C
until the measurements were performed.

2.12. Multivariate Analysis

Python software (Python Software Foundation, Wilmington, NC, USA) was used to execute a
multivariate analysis of the experimental SER spectra. Before being analyzed, all the experimental
data have been baseline corrected using the Wire software (Wire Swiss GmbH Zug, Switzerland).
Data preprocessing includes spectral normalization by mean intensity. Further predictive analysis was
performed using the Pandas package, where Principal Component Analysis (PCA) combined with
Linear Discriminant Analysis (LDA) due to their Scikit-learn implementation.

3. Results and Discussions

The first major goal of this study was the synthesis of solid plasmonic substrates using as
building blocks spherical hydroxylamine reduced silver NPs suitable for SERS measurements on
bio-fluids. Once the synthesis procedure completed, the colloidal solutions were purified and
concentrated by means of TFF method, which turned out to be a critical step for the use of the
currently-proposed solid substrates for SERS measurements on blood plasma. As previously shown,
TFF is an alternative technique for purification, concentration, and size-selection of polydisperse
colloids [26–28]. By removing the chemical by-products produced during the synthesis process, the TFF
allowed a better interaction of the small plasmatic biomolecules with the plasmonic substrate. On the
other hand, the TFF purification improved the dimensional polydispersity of the AgHya NPs as it
has been observed from the UV-VIS absorption measurements perform before and after colloidal
purification (Figure 1). At a careful examination of the two absorbance spectra one can observe a 16%
reduction of the Full Width Half Maximum (FWHM) value after the purification (100 nm versus 84 nm).
This could explain the high degree of reproducibility of the SER spectra recorded on plasma samples,
which are presented in this study. TEM measurements (performed on purified samples) confirmed
the successful synthesis and purification of quasi-spherical silver NPs, as illustrated in Figure S1.
Nanomaterials 2020, 10, 1212 6 of 15

Nanomaterials 2020, 10, x FOR PEER REVIEW 6 of 15

The statistical analysis, performed on a large number of NPs from the TEM images, indicated a mean
indicated a mean
diameter value diameter
of ~33 nm andvalue of degree
a high ~33 nmofand a high degree(inset
mono-dispersity of mono-dispersity (inset Figure
Figure 1). The statistical 1).
analysis
The statistical analysis has been performed
has been performed on more than 200 NPs. on more than 200 NPs.

1. Superposition
Figure 1. Superpositionofofthe normalized
the normalized UV-VIS absorption
UV-VIS spectra
absorption of AgHya
spectra colloidcolloid
of AgHya recorded before
recorded
(red curve)
before (red and afterand
curve) (blue curve)
after purification.
(blue The opticalThe
curve) purification. image of theimage
optical purified
of colloid together
the purified with
colloid
the statistical
together with analysis of their
the statistical dimensions
analysis aredimensions
of their shown in the
areinset.
shown in the inset.

These values
These values are
are in
in good
good correlation with the
correlation with the UV-VIS
UV-VIS absorption
absorption measurements,
measurements, as as the
the colloid
colloid
exhibits a narrower, well-defined surface plasmon resonance band and low extinction
exhibits a narrower, well-defined surface plasmon resonance band and low extinction values at high values at high
wavelengths after the purification. NTA measurements re-confirmed the previous
wavelengths after the purification. NTA measurements re-confirmed the previous results and results and provided
additionaladditional
information: NP’s concentration has a value of ~4 a× 10 10
provided information: NP’s concentration has valueNPs/mL.
of ~4 ×NPs1010composition
NPs/mL. NPs has
been also confirmed by means of Energy Dispersive Spectroscopy (EDS) technique
composition has been also confirmed by means of Energy Dispersive Spectroscopy (EDS) technique (Figure S2).
Once
(Figure S2).purified and concentrated, the silver NPs were poured on top of a CaF2 substrate heated
◦ C and let dry for 80 s. A typical atomic force microscopy (AFM) image of the solid substrate
at 40Once purified and concentrated, the silver NPs were poured on top of a CaF2 substrate heated
formed
at 40 °Cby andheat
letinduced
dry for 80NPss. self-assembling
A typical atomic is force
presented in Figure
microscopy 2. Theimage
(AFM) AFM ofimage has been
the solid taken
substrate
in a region
formed that induced
by heat contains NPs
an uncovered zone ofisCaF
self-assembling 2 glass in
presented that has been
Figure used
2. The AFMas image
reference. The height
has been taken
profile (presented in the inset) indicates that the mean height of the substrate (with respect
in a region that contains an uncovered zone of CaF2 glass that has been used as reference. The height to the glass)
profile (presented in the inset) indicates that the mean height of the substrate (with respect to into
has a value of ~120 nm. In the highest points of the substrate it does not exceed 200 nm. By taking the
account, the mean value of AgHya NPs diameter of ~33 nm (as deduced from TEM
glass) has a value of ~120 nm. In the highest points of the substrate it does not exceed 200 nm. By images statistical
analysis)
taking one
into can conclude
account, the meanthatvalue
the substrate
of AgHyacontains severalof
NPs diameter layers of AgHya
~33 nm NPs self-assembled
(as deduced from TEM images in a
three-dimensional
statistical analysis)(3D)
one manner onto the
can conclude glass
that the substrate.
substrate contains several layers of AgHya NPs self-
assembled in a three-dimensional (3D) manner onto the glass substrate.
Nanomaterials 2020, 10, 1212 7 of 15
Nanomaterials 2020, 10, x FOR PEER REVIEW 7 of 15

Figure
Figure 2. 52.×55× µm
5 µm topographicimages
2
2 topographic images ofof the
the silver
silversolid
solidsubstrate
substrateacquired in in
acquired magnitude mode
magnitude (left)(left)
mode
and height mode (center). The phase image of the same area is presented on the right image. A height
and height mode (center). The phase image of the same area is presented on the right image. A height
profile is highlighted in the inset of the central image.
profile is highlighted in the inset of the central image.

TheThephasephase image indicates that material composition is quite homogeneous in the regions where
image indicates that material composition is quite homogeneous in the regions where
the NPs are present, arguably due to the tangential flow filter (TFF) purification step that was
the NPs are present, arguably due to the tangential flow filter (TFF) purification step that was performed
performed prior to substrate formation. It has been shown that AFM phase images can be successfully
prior to substrate formation. It has been shown that AFM phase images can be successfully employed
employed for proving the presence of molecular species on the edges of anisotropic gold NPs [19].
for proving the presence of molecular species on the edges of anisotropic gold NPs [19]. By reducing
By reducing the number of the molecules present in the very close vicinity of the substrate, the
the diagnostic
number ofrelevant
the molecules presentbiomolecules,
small analyte in the very close
whichvicinity
are found of the substrate,
in very the diagnosticin
small concentrations relevant
the
small analyte are
biofluids, biomolecules,
“allowed” to which arethe
occupy found in very active
plasmonic small concentrations
sites. In this way, in the biofluids,
their are “allowed”
contribution to the
to occupy the plasmonic
vibrational spectrum can active sites. In thisenhanced.
be considerably way, theirThis
contribution
is the reasonto the
wevibrational spectrum
tested the capacity can be
of the
considerably
proposed solid substrate for SERS-based BC detection, based on Multivariate Analysis (MVA) of for
enhanced. This is the reason we tested the capacity of the proposed solid substrate
SERS-based
vibrational BCspectra,
detection,
and based
recorded on on
Multivariate
blood plasma Analysis
samples (MVA)
of BC of vibrational
patients spectra, and recorded
and controls.
on bloodThe enhancement
plasma samplescapabilities
of BC patientsof the
andplasmonic
controls.substrate have been tested firstly on methylene
blue
The(MB), which is acapabilities
enhancement standard analyte
of theinplasmonic
SERS. Thesubstrate
spectra were haverecorded on a large
been tested firstlyarea (60 × 60
on methylene
µm 2) area and the quality of the recorded spectra was found to be quite remarkable. A typical SER
blue (MB), which is a standard analyte in SERS. The spectra were recorded on a large area (60 × 60 µm2 )
areaspectrum of MB isofpresented
and the quality the recordedin Figure
spectraS3. was
The found
secondto tested analyte
be quite was rhodamine
remarkable. 6G (R6G).
A typical This
SER spectrum
analyte was used in a first instance for testing the reproducibility of the recorded spectra and it was
of MB is presented in Figure S3. The second tested analyte was rhodamine 6G (R6G). This analyte was
also used for the calculation of substrate’s enhancement factor (EF). In a typical procedure, 1µL
used in a first instance for testing the reproducibility of the recorded spectra and it was also used for
solution of 10−3 M R6G was poured onto the substrate and left to dry. Sixteen spectra were collected
the calculation of substrate’s enhancement factor (EF). In a typical procedure, 1µL solution of 10−3 M
on a 60 × 60 µm2 substrate area. An optical image of the substrate covered with R6G dried analyte is 2
R6Gpresented
was poured onto the substrate and left to dry. Sixteen spectra were collected on a 60 × 60 µm
in Figure S4. A typical SER spectrum of R6G is presented in Figure S5. As it can be seen in
substrate
the inset of Figureoptical
area. An S5, the image
variationof of
thethesubstrate covered
most intense with R6G
vibrational peak dried
of R6Ganalyte
(1508 cm is−1presented
) was less in
Figure
thanS4.
10%.A typical
The heatSER map,spectrum of R6G
created using theisintensities
presentedofinthisFigure
peak,S5. As it can
collected on be seen inregions
different the insetof of
Figure
the S5, the variation
substrate, is a clearof evidence
the most of intense
that. A vibrational
value of ~3 peak
× 10of R6Gbeen
3 has (1508 cm−1 ) was
calculated for less than 10%.
substrate’s
Theenhancement
heat map, createdfactor using the intensities
(EF). This of this
value has been peak, collected
obtained by comparing on different
Ramanregions
(Figure ofS6)the
and substrate,
SER
is a spectra
clear evidence
of R6G.of that.
All the A valuenecessary
details 3
of ~3 × 10forhas EF been calculated
calculation for substrate’s
are presented in theenhancement
Supplementary factor
(EF).Information
This valuesection.
has been obtained by comparing Raman (Figure S6) and SER spectra of R6G. All the
For a proper
details necessary assessment
for EF calculation of inter-batch
are presented reproducibility capacities of
in the Supplementary our substrates
Information we have
section.
synthesized and purified 3 batches of colloids (batch #1, batch #2
For a proper assessment of inter-batch reproducibility capacities of our substrates & batch #3) using the protocol
we have
described in the materials and methods section. Five different solid substrates
synthesized and purified 3 batches of colloids (batch #1, batch #2 & batch #3) using the protocol have been prepared
using each batch of TFF purified colloidal silver. Then, a blood plasma sample collected from one
described in the materials and methods section. Five different solid substrates have been prepared
donor, has been measured on each solid substrate in order to evaluate inter- and intra-batch
using each batch of TFF purified colloidal silver. Then, a blood plasma sample collected from one donor,
reproducibility of SER spectra. In order to prove the spectral reproducibility, we have plotted the
has been measured on each solid substrate in order to evaluate inter- and intra-batch reproducibility
of SER spectra. In order to prove the spectral reproducibility, we have plotted the bands intensity in
Nanomaterials 2020, 10, 1212 8 of 15

counts/(mW × s) units. The linear dependence of SERS intensity with the laser power (measured at
the sample surface) in the case of the most intense vibrational band of plasma (640 cm−1 ) is shown
in Figure S7. In Figure S8–10, we plotted the SER spectra collected on 15 substrates created using
colloidal batch #1, batch #2 respectively batch#3 (5 substrates for each batch). Each spectrum represents
the mean value of 25 individual spectra collected on different regions of the substrate. Prior to any
measurements, we recorded the SER spectra of the bare substrates. The mean value is also included in
Figures S8–S10. All vibrational peaks identified in the spectra belong to blood plasma components.
The contribution of the naked substrate to the SERS signal is negligible. The main peak in the SER
spectrum of the substrate (1056 cm−1 ) might be assigned to the nitrate group from the silver salt
precursor. It has an intensity of some tens of times smaller, as compared to the blood plasma peaks.
Moreover, no peak or shoulder at this wavenumber can be noticed in the plasma spectra. A careful
examination of the recorded spectra indicates that the ratio between the intensities of the two most
intense vibrational peaks (i.e., 640 & 1134 cm−1 ) has a value between 1.36 and 1.51 (~5% of variation
around the mean value of 1.43).
Inter-batch reproducibility was evaluated by plotting the mean values of the SER spectra collected
on the substrates created using batch #1, batch #2 & batch #3 (Figure S11). All the spectra have been
recorded on the same blood plasma sample collected from one donor. As it can be seen in the figure, the
two spectra are almost identical. This superposition is a clear evidence of inter-batch reproducibility
capacities of the substrates, especially in the case of SERS measurements performed on biofluids.
This high degree of reproducibility represents a necessary condition that needs to be fulfilled prior to
any “diagnostic relevant” PCA-LDA analysis.
A typical Raman spectrum of one plasma sample is presented in Figure 3. The spectrum has been
recorded in out of resonance conditions, using an excitation wavelength of 785 nm (NIR domain),
capable to reduce the inherent fluorescence background, in the 350–3200 cm−1 spectral interval.
As expected from previous reported Raman/SERS studies perform on blood samples the spectrum is
dominated by large proteins, the best confirmation being the presence of the two protein specific bands
located at 1650 cm−1 (Amide I) and 1250 cm−1 (Amide III) [15]. The similarity of the Raman/SERS
spectra of the plasma samples collected from healthy donors and cancer patients is one of the major
scientific problem that needs to be addressed in order to allow the use of Raman/SERS-based techniques
in clinical practice. We deeply believe that the answer to this stringent question can be found by
designing a suitable plasmonic substrate for SERS measurements on biofluids.
The most intense band in the Raman spectrum (1445 cm−1 ) can be assigned to CH2 /CH3
deformations together with the three bands located in the 2800–3100 cm−1 region. These bands
were also detected in the case of a liposomal suspension containing a lipidic bilayer [29,30] and they
suggest the presence of different types of lipids in plasma. The second most intense peak in the Raman
spectrum can be assigned to an aromatic amino acid (Phenylalanine ~1003 cm−1 ), commonly present
in the spectrum of all types of biofluids. These findings are very similar with those presented in the
scientific literature [8–16] and point out the fact that Raman spectra of plasma samples do not contain
specific and diagnostic relevant information.
In order to enhance the spectral information that could be provided by small biomolecules, SERS
measurements have been performed on plasma samples collected from healthy donors and BC patients
by using the solid silver plasmonic substrates (SSPS) synthesized in this study.
In Figure 4, the SER spectra of 35 blood plasma samples collected from healthy donors are presented.
In the light of previous studies, careful examination leads to the idea that xanthine derivatives have a
major contribution to the vibrational spectra of these samples. As such, the 640, 725, and 1248 cm−1
peaks may be attributed to ring stretching vibrations of uric acid and hypoxanthine whilst 495, 811, 890,
1132, and 1205 cm−1 peaks may be attributed to uric acid. The 954 & 1331 cm−1 peaks can be assigned
to hypoxanthine [15,16]. The amino acid fraction, especially aromatic amino acids such as tyrosine and
phenylalanine, also have an important contribution to SER spectra. These two amino acids could be
responsible for 640 and 725 cm−1 twisting vibrational peaks. They might have individual contributions
 reproducibility capacities of the substrates, especially in the case of SERS measurements performed
on biofluids. This high degree of reproducibility represents a necessary condition that needs to be
fulfilled prior to any “diagnostic relevant” PCA-LDA analysis.
A typical Raman spectrum of one plasma sample is presented in Figure 3. The spectrum has
been recorded in out of resonance conditions, using an excitation wavelength of 785 nm (NIR
Nanomaterials
domain), 2020,
capable10, 1212
to reduce the inherent fluorescence background, in the 350–3200 cm−1 spectral 9 of 15
interval. As expected from previous reported Raman/SERS studies perform on blood samples the
spectrum is dominated by large proteins, the best confirmation−1being the presence of the two protein
to 848, and 1132 cm−1 (tyrosine) and 1004, 1205, and 1575 cm (phenylalanine). On the other hand,
specific bands
Nanomaterials 2020,located
10, x FORat 1650
PEER cm−1 (Amide I) and 1250 cm−1 (Amide III) [15]. The similarity of
REVIEW 9 ofthe
15
purine bases (adenine, guanine) bring a smaller but still relevant contribution to the SER spectral
Raman/SERS spectra of the plasma samples collected from healthy donors and cancer patients is one
pattern ofmajor
blood
of theFigure plasma
3.scientific
Typical samples.
problem
Raman Theneeds
that
spectrum stretching
of to be
blood ringacquired
vibration
addressed
plasma of aguanine
inusing
order to
785allow contributes to the 495 cm−1
the use wavelength.
nm excitation of Raman/SERS-
peak,
basedwhereas
techniquesthe inbending
clinical C–H vibrations
practice. We deeplyof adenine molecules
believe that contribute
the answer to 725 and
to this stringent 1332can
question cm−1
peaks [31–37].
The by
be found most intense aband
designing in plasmonic
suitable the Ramansubstrate
spectrum for (1445 cm−1) can be assigned
SERS measurements to CH2/CH3
on biofluids.
deformations together with the three bands located in the 2800–3100 cm−1 region. These bands were
also detected in the case of a liposomal suspension containing a lipidic bilayer [29,30] and they
suggest the presence of different types of lipids in plasma. The second most intense peak in the
Raman spectrum can be assigned to an aromatic amino acid (Phenylalanine ~1003 cm−1), commonly
present in the spectrum of all types of biofluids. These findings are very similar with those presented
in the scientific literature [8–16] and point out the fact that Raman spectra of plasma samples do not
contain specific and diagnostic relevant information.
In order to enhance the spectral information that could be provided by small biomolecules, SERS
measurements have been performed on plasma samples collected from healthy donors and BC
patients by using the solid silver plasmonic substrates (SSPS) synthesized in this study.
In Figure 4, the SER spectra of 35 blood plasma samples collected from healthy donors are
presented. In the light of previous studies, careful examination leads to the idea that xanthine
derivatives have a major contribution to the vibrational spectra of these samples. As such, the 640,
725, and 1248 cm−1 peaks may be attributed to ring stretching vibrations of uric acid and hypoxanthine
whilst 495, 811, 890, 1132, and 1205 cm−1 peaks may be attributed to uric acid. The 954 & 1331 cm−1
peaks can be assigned to hypoxanthine [15,16]. The amino acid fraction, especially aromatic amino
acids such as tyrosine and phenylalanine, also have an important contribution to SER spectra. These
two amino acids could be responsible for 640 and 725 cm−1 twisting vibrational peaks. They might
have individual contributions to 848, and 1132 cm−1 (tyrosine) and 1004, 1205, and 1575 cm−1
(phenylalanine). On the other hand, purine bases (adenine, guanine) bring a smaller but still relevant
contribution to the SER spectral pattern of blood plasma samples. The stretching ring vibration of
guanine contributes to the 495 cm−1 peak, whereas the bending C–H vibrations of adenine molecules
contribute to 725 and 1332 cm−1 peaks [31–37].
Figure 3. Typical Raman spectrum of blood plasma acquired using a 785 nm excitation wavelength.

Figure
Figure4. 4.Surface
SurfaceEnhanced
Enhanced Raman
Raman (SER) spectraof
(SER) spectra ofblood
bloodplasma
plasmasamples
samples obtained
obtained from
from healthy
healthy
donors
donors (n(n= =35)
35)recorded
recordedononthe
the solid
solid silver plasmonicsubstrates
silver plasmonic substrates(SSPSs)
(SSPSs) using
using a 785
a 785 nmnm excitation
excitation
laser. The
laser. Themean
meanspectrum
spectrumisishighlighted
highlighted inin green. The spectra
green. The spectrawere
werenormalized
normalizedtoto the
the 640
640 cmcm −1 peak.
−1 peak.
Nanomaterials 2020, 10, 1212 10 of 15

Other small molecules, belonging to a multitude of biochemical classes such as amino acids
(proline, L-serine, tryptophan), oligopeptides (glutathione), saccharides (D-mannose, D-galactosamine),
lipids, vitamins (riboflavin, ascorbic acid) can contribute to the SER spectral pattern of blood plasma,
as it has been previously suggested [30–35].
Given the aforementioned arguments one can conclude that the main contributions in the SER
spectra of blood plasma samples collected from healthy donors and recorded on our SSPSs are due to
small non-protein biomolecules (molecular mass below 1 kDa). A possible explanation for this finding
could be their higher affinity for this type of nanostructured solid substrate.
The same phenomena were detected in the case of the plasma samples collected from 29 BC
patients (Figure 5). The spectra have been recorded in the same conditions and on the same type of
substrates. The vast majority of the vibrational bands can be found in both spectra by superposing
the Nanomaterials
normalized mean
2020, spectra
10, x FOR recorded on donors and BC patients’ samples (Figure 6). The
PEER REVIEW 10 of small
15
intensity differences can be detected in the blue highlighted zones from Figure 6. These small spectral
differences Other
aresmall
unable molecules,
to clearlybelonging
differentiateto athe
multitude of biochemical
BC patients classes such
from the healthy as amino
donors, but theacids
quality
and(proline,
high degreeL-serine, tryptophan), ofoligopeptides
of reproducibility the SER spectra (glutathione),
represent a saccharides (D-mannose,
very good starting point forD- the
galactosamine),
Multivariate Analysis. lipids, vitamins (riboflavin, ascorbic acid) can contribute to the SER spectral pattern
ofTherefore,
blood plasma, as it hasPrincipal
a combined been previously
Componentsuggested [30–35].
Analysis-Linear Discriminant Analysis (PCA-LDA) of
Given the aforementioned arguments one can conclude that the main contributions in the SER
all SER spectra was performed in order to test the capacity of this multivariate approach to separate the
spectra of blood plasma samples collected from healthy donors and recorded on our SSPSs are due
two groups of samples: BC versus control. PCA is used to transform the data into a lower-dimensional
to small non-protein biomolecules (molecular mass below 1 kDa). A possible explanation for this
space such that the explained variance is maximized for the new dimensionality. This is achieved
finding could be their higher affinity for this type of nanostructured solid substrate.
by selecting a number
The same of components—perpendicular
phenomena were detected in the case oflinear directions
the plasma in the
samples original
collected space—and
from 29 BC
projecting the data onto them. By choosing these components to maximize
patients (Figure 5). The spectra have been recorded in the same conditions and on the same type the variance retained
of
in the new space, PCA essentially filters out a large number of noise dimensions.
substrates. The vast majority of the vibrational bands can be found in both spectra by superposing Figure 7 shows
the the
relationship
normalized between the percentage
mean spectra recorded of onexplained
donors and variance and the
BC patients’ number
samples of PCA
(Figure components
6). The small
(i.e.,intensity
dimensionality
differences of can
thebenew space).
detected in In
theour
blueexperiments, we chose
highlighted zones 11 components
from Figure which
6. These small explain
spectral
differences
99.09% are unableIntoFigure
of the variance. clearlyS12
differentiate
we plotted thethe
BCloading
patientscurves
from the forhealthy donors,
the first but the quality
15 components. As can
and high degree of reproducibility of the SER spectra represent a very
be seen, the loading curve for the 11th component shows identifiable spectral features besidesgood starting point for the the
Multivariate
noise. Analysis.
As a result, choosing 11 components does not lead to any overfitting.

Figure 5. SER
Figure spectra
5. SER ofof
spectra blood
bloodplasma
plasmasamples
samples obtained fromBC
obtained from BCpatients = 29)
patients(n(n= 29) recorded
recorded on on SSPSs
SSPSs
using a 785
using nmnm
a 785 excitation
excitationlaser.
laser.The
Thespectra
spectrawere
were normalized tothe
normalized to the640
640cm
cm −1 −1 peak.
peak.
Nanomaterials 2020, 10, 1212 11 of 15
Nanomaterials 2020, 10, x FOR PEER REVIEW 11 of 15

Figure 6. Overlapping
Figure 6. Overlappingofof
the
themean
meanSER
SERspectra
spectra recorded
recorded ononthe
theblood
bloodplasma
plasma samples
samples collected
collected from
from
healthy subjects
healthy (green
subjects spectrum)
(green spectrum)and
andBC
BCpatients
patients (red spectrum)recorded
(red spectrum) recordedonon SSPSs
SSPSs using
using a 785
a 785 nmnm
excitation laser.
excitation The
laser. spectra
The were
spectra werenormalized
normalizedtoto the cm−1−1peak.
the 640 cm peak.

TheTherefore,
spectral data, transformed
a combined by PCA,
Principal was usedAnalysis-Linear
Component as input for an LDA discriminator,
Discriminant which
Analysis finds a
(PCA-
LDA)
linear of all SER
boundary spectraBC
between was performed
and control. in order
This to test the
boundary capacity of
is obtained bythis multivariate
maximizing theapproach to
ratio between
the separate the
between-class
Nanomaterials two groups
2020, 10,variance
x FOR PEERof
andsamples: BC versus control.
within-class variance.
REVIEW PCA is used to transform the data into12aof 15
lower-dimensional space such that the explained variance is maximized for the new dimensionality.
This is achieved by selecting a number of components—perpendicular linear directions in the original
space—and projecting the data onto them. By choosing these components to maximize the variance
retained in the new space, PCA essentially filters out a large number of noise dimensions. Figure 7
shows the relationship between the percentage of explained variance and the number of PCA
components (i.e., dimensionality of the new space). In our experiments, we chose 11 components
which explain 99.09% of the variance. In Figure S12 we plotted the loading curves for the first 15
components. As can be seen, the loading curve for the 11th component shows identifiable spectral
features besides the noise. As a result, choosing 11 components does not lead to any overfitting.
The spectral data, transformed by PCA, was used as input for an LDA discriminator, which finds
a linear boundary between BC and control. This boundary is obtained by maximizing the ratio
between the between-class variance and within-class variance.

Figure
Figure 7. Explained variance
7. Explained variance as
as aa function
function of
of Principal
Principal Component
Component Analysis
Analysis (PCA)
(PCA) components.
components.

The
The dataset
dataset consisted
consisted of
of 64
64 data
data points
points represented
represented byby 35
35 control
control and
and 29
29 BC
BC patients.
patients. Because
Because of
of
the
the relatively small dataset, Leave-One-Out Cross-Validation (LOOCV) was used to perform the
relatively small dataset, Leave-One-Out Cross-Validation (LOOCV) was used to perform the
analysis,
analysis, i.e.,
i.e.,the
thePCA
PCAand
andLDA
LDAwere
were trained
trainedonon
all all
butbut
oneone
datadata
point; the left-out
point; data data
the left-out pointpoint
was then
was
processed by PCA and had its label (cancer/control) predicted by LDA. The true and predicted
then processed by PCA and had its label (cancer/control) predicted by LDA. The true and predicted classes
classes were recorded for each individual data point using this scheme. The results of PCA-LDA
analysis, obtained by LOOCV, are presented in Table I.
As it can be seen in Table 1, the BC patients can be distinguished from healthy donors with a
sensitivity (S) of 90%, a specificity (S) of 89% and an accuracy (A) of 89%, The results are very
promising given that mammography, which represents today the golden standard in BC detection,
Nanomaterials 2020, 10, 1212 12 of 15

were recorded for each individual data point using this scheme. The results of PCA-LDA analysis,
obtained by LOOCV, are presented in Table 1.
As it can be seen in Table 1, the BC patients can be distinguished from healthy donors with a
sensitivity (S) of 90%, a specificity (S) of 89% and an accuracy (A) of 89%, The results are very promising
given that mammography, which represents today the golden standard in BC detection, can only detect
BC with a sensitivity of 70% and a specificity of 75% [34]. The reported sensitivity, specificity and
accuracy values are very close to those reported by Cervo et al. [15]. In our case, the experimental
spectra have been recorded on pristine plasma samples whereas in their case filtered serum samples
have been used. By removing this additional step of blood sample filtration, the here proposed
discrimination method has the potential of easier implementation in clinical applications for BC or
different types of cancer but further studies are still needed.

Table 1. Results of Principal Component Analysis-Linear Discriminant Analysis (PCS-LDA) analysis

performed on all SER spectra.

True True False False

Accuracy Precision Sensitivity Specificity
Positives Negatives Positives Negatives
0.89 0.87 0.90 0.89 26 31 4 3

4. Conclusions
In this paper, we propose a very simple, cheap and efficient method for the synthesis of solid
plasmonic substrates. The use of Leopold-Lendl Ag colloids purified and concentrated by means
of the TFF method, drop-casted in controlled temperature conditions on a silent Raman CaF2 glass.
To the best of our knowledge this is the first time, when such a substrate is proposed in the literature.
Using these very simple and cheap conditions, we obtained highly reproducible SERS signals for a
very complex analyte like blood plasma.
Once synthesized, the reproducibility of the spectra generated by the substrate were tested on
a typical Raman analyte as well as on a blood plasma sample. Then the substrates were used for
recording SER spectra from pristine blood plasma samples collected from 35 healthy donors and 29 BC
patients. A PCA-LDA analysis was used to statistically differentiate the SER spectra, collected from the
two clinically different groups. This allowed the distinction between healthy donors and BC patients
with high sensitivity and specificity (90% sensitivity and 89% specificity). Without performing any
other purification or deproteinization step, a diagnostic accuracy of 89% was obtained performing the
SERS measurements directly on blood plasma samples. This a direct consequence of SSPSs ability to
generate reproducible and diagnostic relevant spectral information.
In conclusion, the solution to the reproducibility problem of SERS analysis can be resolved by the
substrate and its subsequent optimization. In the future, we hope that our results generate enough
interest that this type of solid silver substrates could also be employed for SERS based detection of
other types of cancer.

Supplementary Materials: The following are available online at http://www.mdpi.com/2079-4991/10/6/1212/s1,

Figure S1: TEM image and size distribution plot of the purified quasi-spherical AgHya NPs, Figure S2: EDS
analysis of purified silver colloids, Figure S3: A typical SERS spectrum of methylene blue (MB) 10−5 M recorded,
using a 785 nm excitation laser, Figure S4: Optical image of three different areas of the plasmonic substrate covered
with R6G analyte, Figure S5: SER spectrum of rhodamine 6G (R6G) 10−3 M recorded using an excitation laser of
785 nm. The upper insets present a heat map, showing a very small variation of the most intense vibrational peak
of R6G (1508 cm−1 ). The lower inset presents an optical image of the substrate where the spectra were recorded,
Figure S6: Raman spectrum of rhodamine 6G (R6G) 10−3 M recorded using a 785 nm excitation laser, Figure S7:
Variation of the most intense vibrational band of blood plasma (640 cm−1 ) as a function of excitation laser intensity
measured at the sample surface, Figure S8: SER spectra of blood plasma samples collected on five different solid
substrates created using the same purified colloidal solution (batch 1). Each spectrum represents the mean of
25 individual spectra recorded on different regions of the substrate. The mean SER spectrum recorded on the
5 bare substrates is also plotted for comparison. All the spectra were recorded using the same experimental
conditions. The spectra were offset for clarity, Figure S9: SER spectra of blood plasma samples collected on five
Nanomaterials 2020, 10, 1212 13 of 15

different solid substrates created using the same purified colloidal solution (batch 2). Each spectrum represents
the mean of 25 individual spectra recorded on different regions of the substrate. The mean SER spectrum of the
five bare substrates is also plotted for comparison. All the spectra were recorded using the same experimental
conditions. The spectra were offset for clarity, Figure S10: SER spectra of blood plasma samples collected on five
different solid substrates created using the same purified colloidal solution (batch 3). Each spectrum represents
the mean of 25 individual spectra recorded on different regions of the substrate. The mean SER spectrum of the
five bare substrates is also plotted for comparison. All the spectra were recorded using the same experimental
conditions. The spectra were offset for clarity, Figure S11. Superposition of the mean spectra collected on the
substrates fabricated using the colloidal batch #1 (red spectrum), #2 (blue spectrum) and #3 (green spectrum).
All the spectra were recorded using the same experimental conditions on the same plasma sample, Figure S11.
Loading curves of the first 15 principal components.
Author Contributions: Conceptualization, R.I.S, ., and I.P.; methodology, V.T., G.F.S, ., R.M., G.M.-B., and C.M.L.;
software, R.M. and V.T.; validation, G.F.S, ., G.M.-B., R.T., B.C., M.B., and N.L.; formal analysis, G.F.S, ., V.T., I.P., N.L.
and R.I.S, .; investigation, G.F.S., V.T., M.B., and R.M.; resources, R.I.S, . and I.P.; data curation, G.F.S, ., V.T. and R.I.S, .;
writing—original draft preparation, G.F.S, ., V.T., I.P., and R.I.S, .; writing—review and editing, R.I.S, ., and C.M.L.;
visualization, G.M.B., N.L., B.C., R.T. and C.M.L.; supervision, R.I.S, ., and C.M.L.; project administration, I.P.,
R.T and R.I.S, .; funding acquisition, I.P., and R.I.S, . All authors have read and agreed to the published version of
the manuscript.
Funding: This research was funded by the Competitiveness Operational Program 2014-2020 POC-A1-A1.1.4-E-2015,
financed under the European Regional Development Fund, project number P_37_765 and by the Romanian
National Authority for Scientific Research, CNCSIS-UEFISCDI, through the research project for exploratory
research No. PN-III-P4-ID-PCCF-2016-0112.
Conflicts of Interest: The authors declare no conflict of interest. The funders had no role in the design of the
study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to
publish the results.

References
1. Weller, D.; Vedsted, P.; Rubin, G.; Walter, F.M.; Emery, J.; Scott, S.; Campbell, C.; Andersen, R.S.; Hamilton, W.;
Olesen, F.; et al. The Aarhus statement: Improving design and reporting of studies on early cancer diagnosis.
Br. J. Cancer 2012, 106, 1262–1267. [CrossRef]
2. Tirpe, A.A.; Gulei, D.; Ciortea, S.M.; Crivii, C.; Berindan-Neagoe, I. Hypoxia: Overview on hypoxia-mediated
mechanisms with a focus on the role of hif genes. Int. J. Mol. Sci. 2019, 20, 6140. [CrossRef]
3. Gøtzsche, P.C.; Olsen, O. Is screening for breast cancer with mammography justifiable? Lancet 2000, 355,
129–134. [CrossRef]
4. Olsen, O.; Gøtzsche, P.C. Cochrane review on screening for breast cancer with mammography. Lancet 2001,
358, 1340–1342. [CrossRef]
5. Bleyer, A.; Welch, H.G. Effect of three decades of screening mammography on breast-cancer incidence. N.
Engl. J. Med. 2012, 367, 1998–2005. [CrossRef] [PubMed]
6. Vogel, V.G. Epidemiology of Breast Cancer. In The Breast; Elsevier: Amsterdam, The Netherlands, 2018;
pp. 207–218.
7. Moisoiu, V.; Stefancu, A.; Gulei, D.; Boitor, R.; Magdo, L.; Raduly, L.; Pasca, S.; Kubelac, P.; Mehterov, N.;
Chis, , V.; et al. SERS-based differential diagnosis between multiple solid malignancies: Breast, colorectal,
lung, ovarian and oral cancer. Int. J. Nanomed. 2019, 14, 6165–6178. [CrossRef] [PubMed]
8. Premasiri, W.R.; Lee, J.C.; Ziegler, L.D. Surface-enhanced Raman scattering of whole human blood, blood
plasma, and red blood cells: Cellular processes and bioanalytical sensing. J. Phys. Chem. B. 2012, 116,
9376–9386. [CrossRef] [PubMed]
9. Harris, A.T.; Lungari, A.; Needham, C.J.; Smith, S.L.; Lones, M.A.; Fisher, S.E.; Yang, X.B.; Cooper, N.;
Kirkham, J.; Smith, D.A.; et al. Potential for Raman spectroscopy to provide cancer screening using a
peripheral blood sample. Head Neck Oncol. Bio. Med. Central. 2009, 1, 34. [CrossRef]
10. Baker, M.J.; Hussain, S.R.; Lovergne, L.; Untereiner, V.; Hughes, C.; Lukaszewski, R.A.; Thiéfin, G.;
Sockalingum, G.D. Developing and understanding biofluid vibrational spectroscopy: A critical review. Chem.
Soc. Rev. 2016, 45, 1803–1818. [CrossRef]
11. Butler, H.J.; Ashton, L.; Bird, B.; Cinque, G.; Curtis, K.; Dorney, J.; Esmonde-White, K.; Fullwood, N.J.;
Gardner, B.; Martin-Hirsch, P.L.; et al. Using Raman spectroscopy to characterize biological materials. Nat.
Protoc. 2016, 11, 664–687. [CrossRef]
Nanomaterials 2020, 10, 1212 14 of 15

12. Baker, M.J.; Byrne, H.J.; Chalmers, J.; Gardner, P.; Goodacre, R.; Henderson, A.; Kazarian, S.G.; Martin, F.L.;
Moger, J.; Stone, N.; et al. Clinical applications of infrared and Raman spectroscopy: State of play and future
challenges. Analyst 2018, 143, 1735–1757. [CrossRef] [PubMed]
13. Bonifacio, A.; Cervo, S.; Sergo, V. Label-free surface-enhanced Raman spectroscopy of biofluids: Fundamental
aspects and diagnostic applications. Anal. Bioanal. Chem. 2015, 407, 8265–8277. [CrossRef] [PubMed]
14. Enejder, A.M.K.; Koo, T.-W.; Oh, J.; Hunter, M.; Sasic, S.; Feld, M.S.; Horowitz, G.L. Blood analysis by Raman
spectroscopy. Opt. Lett. 2002, 27, 2004–2006. [CrossRef] [PubMed]
15. Bonifacio, A.; Dalla Marta, S.; Spizzo, R.; Cervo, S.; Steffan, A.; Colombatti, A.; Sergo, V. Surface-enhanced
Raman spectroscopy of blood plasma and serum using Ag and Au nanoparticles: A systematic study. Anal.
Bioanal. Chem. 2014, 406, 2355–2365. [CrossRef] [PubMed]
16. Cervo, S.; Mansutti, E.; Del Mistro, G.; Spizzo, R.; Colombatti, A.; Steffan, A.; Sergo, V.; Bonifacio, A. SERS
analysis of serum for detection of early and locally advanced breast cancer. Anal. Bioanal. Chem. Springer
2015, 407, 7503–7509. [CrossRef]
17. Banholzer, M.J.; Millstone, J.E.; Qin, L.; Mirkin, C.A. Rationally designed nanostructures for surface-enhanced
Raman spectroscopy. Chem. Soc. Rev. 2008, 37, 885. [CrossRef]
18. Stiufiuc, R.; Iacovita, C.; Lucaciu, C.M.; Stiufiuc, G.; Dutu, A.G.; Braescu, C.; Leopold, N. SERS-active silver
colloids prepared by reduction of silver nitrate with short-chain polyethylene glycol. Nanoscale Res. Lett.
Springer 2013, 8, 47. [CrossRef]
19. Stiufiuc, R.; Toderas, F.; Iosin, M.; Stiufiuc, G. Anisotropic gold nanocrystals: Synthesis and characterization.
Int. J. Mod. Phys. B 2010, 24, 757–761. [CrossRef]
20. Stiufiuc, R.; Iacovita, C.; Nicoara, R.; Stiufiuc, G.; Florea, A.; Achim, M.; Lucaciu, C.M. One-step synthesis of
PEGylated gold nanoparticles with tunable surface charge. J. Nanomater. Hindawi. 2013, 2013, 1–7. [CrossRef]
21. Stiufiuc, G.; Toma, V.; Moldovan, A.; Stiufiuc, R.; Lucaciu, M. One pot microwave assisted synthesis of
cyclodextrins capped spherical gold nanoparticles. Dig. J. Nanomater. Biostructures 2017, 12, 1089–1095.
22. Nit, ică S, tefan Moldovan, A.I.; Toma, V.; Moldovan, C.S.; Berindan-Neagoe, I.; S, tiufiuc, G.; Lucaciu, C.M.;
S, tiufiuc, R. PEGylated gold nanoparticles with interesting plasmonic properties synthesized using an original,
rapid, and easy-to-implement procedure. J. Nanomater. Hindawi. 2018, 2018, 1–7. [CrossRef]
23. Stiufiuc, R.; Iacovita, C.; Stiufiuc, G.; Bodoki, E.; Chis, V.; Lucaciu, C.M. Surface mediated chiral interactions
between cyclodextrins and propranolol enantiomers: A SERS and DFT study. Phys. Chem. Chem. Phys. 2015,
17, 1281–1289. [CrossRef] [PubMed]
24. Bodoki, E.; Oltean, M.; Bodoki, A.; Ştiufiuc, R. Chiral recognition and quantification of propranolol
enantiomers by surface enhanced Raman scattering through supramolecular interaction with β-cyclodextrin.
Talanta. Elsevier 2012, 101, 53–58. [CrossRef] [PubMed]
25. Leopold, N.; Lendl, B. A new method for fast preparation of highly surface-enhanced Raman scattering (SERS)
active silver colloids at room temperature by reduction of silver nitrate with hydroxylamine hydrochloride.
J. Phys. Chem. B. 2003, 107, 5723–5727. [CrossRef]
26. Anders, C.B.; Baker, J.D.; Stahler, A.C.; Williams, A.J.; Sisco, J.N.; Trefry, J.C.; Wooley, D.P.; Pavel Sizemore, I.E.
Tangential flow ultrafiltration: A “green” method for the size selection and concentration of colloidal silver
nanoparticles. J. Vis. Exp. 2012, 68, e4167. [CrossRef]
27. Dorney, K.M.; Baker, J.D.; Edwards, M.L.; Kanel, S.R.; O’Malley, M.; Pavel Sizemore, I.E. Tangential flow
filtration of colloidal silver nanoparticles: A “Green” laboratory experiment for chemistry and engineering
students. J. Chem. Educ. 2014, 91, 1044–1049. [CrossRef]
28. Trefry, J.C.; Monahan, J.L.; Weaver, K.M.; Meyerhoefer, A.J.; Markopolous, M.M.; Arnold, Z.S.; Wooley, D.P.;
Pavel, I.E. Size selection and concentration of silver nanoparticles by tangential flow ultrafiltration for
SERS-based biosensors. J. Am. Chem. Soc. 2010, 132, 10970–10972. [CrossRef]
29. Stiufiuc, R.; Iacovita, C.; Stiufiuc, G.; Florea, A.; Achim, M.; Lucaciu, C.M. A new class of pegylated plasmonic
liposomes: Synthesis and characterization. J. Colloid Interface Sci. 2015, 437, 17–23. [CrossRef]
30. S, tiufiuc, G.F.; Nit, ică, S.; Toma, V.; Iacovit, ă, C.; Zahn, D.R.T.; Tetean, R.; Burzo, E.; Lucaciu, C.M.;
S, tiufiuc, R.I. Synergistical use of electrostatic and hydrophobic interactions for the synthesis of a new
class of multifunctional nanohybrids: Plasmonic magneto-liposomes. Nanomaterials 2019, 9, 1623. [CrossRef]
31. Lin, D.; Pan, J.; Huang, H.; Chen, G.; Qiu, S.; Shi, H.; Chen, W.; Yu, Y.; Feng, S.; Chen, R. Label-free blood
plasma test based on surface-enhanced Raman scattering for tumor stages detection in nasopharyngeal
cancer. Sci. Rep. 2014, 4, 4751. [CrossRef]
Nanomaterials 2020, 10, 1212 15 of 15

32. Feng, S.; Pan, J.; Wu, Y.; Lin, D.; Chen, Y.; Xi, G.; Lin, J.; Chen, R. Study on gastric cancer blood plasma based
on surface-enhanced Raman spectroscopy combined with multivariate analysis. Sci. China Life Sci. 2011, 54,
828–834. [CrossRef]
33. Lin, J.; Chen, R.; Feng, S.; Pan, J.; Li, Y.; Chen, G.; Cheng, M.; Huang, Z.; Yu, Y.; Zeng, H. A novel blood plasma
analysis technique combining membrane electrophoresis with silver nanoparticle-based SERS spectroscopy
for potential applications in noninvasive cancer detection. Nanomedicine 2011, 7, 655–663. [CrossRef]
[PubMed]
34. González-Solís, J.; Luévano-Colmenero, G.; Vargas-Mancilla, J. Surface enhanced Raman spectroscopy in
breast cancer cells. Laser 2013, 22, 37–42.
35. Feng, S.; Lin, D.; Lin, J.; Li, B.; Huang, Z.; Chen, G.; Zhang, W.; Wang, L.; Pan, J.; Chen, R.; et al. Blood plasma
surface-enhanced Raman spectroscopy for non-invasive optical detection of cervical cancer. Analyst 2013,
138, 3967. [CrossRef] [PubMed]
36. Li, S.; Li, L.; Zeng, Q.; Zhang, Y.; Guo, Z.; Liu, Z.; Jin, M.; Su, C.; Lin, L.; Xu, J.; et al. Characterization and
noninvasive diagnosis of bladder cancer with serum surface enhanced Raman spectroscopy and genetic
algorithms. Sci. Rep. 2015, 5, 9582. [CrossRef] [PubMed]
37. Han, X.X.; Ozaki, Y.; Zhao, B. Label-free detection in biological applications of surface-enhanced Raman
scattering. TrAC Trends Anal. Chem. Elsevier 2012, 38, 67–78. [CrossRef]

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC BY) license (http://creativecommons.org/licenses/by/4.0/).